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Contractor Application

Name: ______SSN: ______-______-______

Address: ______Cell: ( __ ) -______

______Home: ( ) - ______

Email Address: ______Gender Male Female

Drivers License Number: ______D.O.B: ______

Previous Employment History
Company Name / Start Date / End Date / Job Duties
Company Name / Start Date / End Date / Job Duties
Company Name / Start Date / End Date / Job Duties

Do you have teaching experience?

No

Yes Please list ______

Please check the days you are AVAILABLE to work: Classes RANGE between 1:30pm-6:30pm

Everyone will have a minimum shift of 2 hours per day and a maximum shift of 3.5 hours per day

Monday Tuesday Wednesday Thursday Friday

Please check the classes you are interested in teaching. Check all that apply.

Please keep in mind that we offer over 75 types of classes (below are just a few samples)

Media Production Art & Arts & Crafts Cooking Dance Science

Music/Instruments Sports Martial Arts Woodshop Cheer

Other: ______

Please list 5 references of whom we may contact. You may include Relatives, Co-Workers, Family and Friends.

First and Last Name / Relationship / Phone Number / Email (optional)

*During your interview you will be required to provide a Lesson Plan that will best describe a class you would be interested in teaching. The lesson should be based upon a plan that can be completed in a single day approximately 1 hour (month long or semester long plans are NOT required)

The lesson plan must be ½ a page long but no more than 1 page.

Use your imagination and be prepared to bring your lesson plan with you on your interview date.

·  Note: Please Bring Application Filled out Entirely Along with Lesson Plan to Interview

·  Only Your DL and Social NUMBER is needed. We do not need a copy.

OFFICE USE ONLY

Notes:

★ ★★ ★★★ ★★★★